Treatment. Yes Or No?

To administer treatment or not to treat is one of the key dilemmas we as physical therapists have to face at some time or other in our work.

This past week I have had two patients in my clinic, both incidentally gentlemen in their sixties with manual jobs, complaining of severe, debilitating low back pain.

Both had 'well worn spines', as you would expect bearing in mind their histories. Both were in severe pain and had very limited mobility after having had minor pain in the back for a week or so and essentially ignoring it, thinking that it would go of its own accord.

In both cases however this did not happen and their respective conditions worsened, until as is so often the case with human nature being as it is, they sought help 'after the horse had bolted' as it were.

Both men had such severe inflammation in their spines that the only thing for them to do was to take bed rest for forty eight/seventy two hours to allow the body to rest and begin the resolution of the inflammation responsible for the pain.

Any form of active input at this stage would only have added energy to the tissues and in all probability caused further physiological aggravation and irritation of nerve endings, thus making the patient feel worse.

Despite patients' pleas for 'curative input' restoration of the status quo is best achieved with, as one of my old doctor friends used to say,ACTIVE REST. Sometimes the hardest thing to do is convince patients that being proactive means rest and rest only initially.

After the initial pain has begun to settle and mobility is slightly better it is time, in my opinion, for therapeutic input to aid the recovery process. So if you are in a situation like this: STOP. THINK AND ASK YOURSELF WHAT IS YOUR BODY SAYING. LISTEN CAREFULLY AND IT MAY BE TELLING YOU TO REST.

You would be well advised to heed the message. There are no medals for bravery in this battle.

To find out more about back pain treatment see our main BACK PAIN page.